STEMI & NSTEMI (Electrocardiography (ECG) basics; ECG/EKG in Sinhala)

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A heart attack with a completely blocked coronary artery is called a STEMI. STEMI stands for ST Elevation Myocardial Infarction. On a heart tracing there is a particular area that is called the ST segment. When this segment is elevated, the person is said to have a STEMI.
The main difference between a STEMI and other heart attacks is the total blockage of the artery and the heart muscle dying. That's why STEMIs are so dangerous-your heart can't pump enough blood to the rest of your body. Non-STEMI heart attacks usually involve an artery with partial blockage.
Evaluation of patients with acute onset of chest pain should begin with an electrocardiogram (ECG) and troponin level. The American College of Cardiology, American Heart Association, European Society of Cardiology, and the World Heart Federation committee established the following ECG criteria for ST-elevation myocardial infarction (STEMI)
New ST-segment elevation at the J point in 2 contiguous leads with the cutoff point as greater than 0.1 mV in all leads other than V2 or V3
In leads V2-V3 the cutoff point is greater than 0.2 mV in men older than 40 years old and greater than 0.25 in men younger than 40 years old, or greater than 0.15 mV in women
Patients with a pre-existing left bundle branch block can be further evaluated using Sgarbossa's criteria.
ST-segment elevation of 1 mm or more that is concordant with (in the same direction as) the QRS complex
ST-segment depression of 1 mm or more in lead V1, V2, or V3
ST-segment elevation of 5 mm or more that is discordant with (in the opposite direction) the QRS complex

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